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General NPI Number Information
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NPI Number | 1437346897
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Entity Type | Individual
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Provider Name | CHARLES CHRISTOPHER SIMONS DDS
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Gender | Male
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | N6141 INDUSTRIAL PARK RD.
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City | WETMORE
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State | MI
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Zip | 49895
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Country | US
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Telephone | 906-387-5000
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Fax | 906-387-5018
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Provider Business Mailing Address
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Address Line | PO BOX 600
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City | MUNISING
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State | MI
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Zip | 49862-0600
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Country | US
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Telephone | 906-387-5000
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Fax | 906-387-5018
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901014593
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License Number State | MI
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